I am a 59 year old female recently dx atrial flutter with some afib. I have the reveal Linq implant. I have an ablation scheduled in 3 weeks at Ohio State University. I'm on Eliquis and Bystolic. I hate Bystolic. I need to get off these drugs. I am a former competitive swimmer and have recently read an article about the higher frequency of afib/flutter in swimmers. Any thoughts or advice?

Hi Cindy, when I was diagnosed with Afib I started swimming as part of my exercise routine and it actually helped. I think in general athletes are prone to afib but then again there are a lot of people who aren't athletes and are suffering from it so who knows. I had an ablation six weeks ago and I was taken off the meds two weeks ago. Good luck with the ablation.

Thanks! I am a veteran of numerous orthopedic surgeries but this ablation scares me. And you are awake. I assume it wasn't a bad experience for you.

I wasn't awake for my ablation. The surgery took 5 hours but everything went well and I left the hospital the next day. You do need to take it easy for the next two weeks or your heart may start racing due to all the inflammation. There are risks with any surgery and this is heart surgery after all. You wil be fine.

Cindy,

A few things/thoughts:

1) I think , typically at this point, patients are not awake during ablations. Can others please comment/verify? I know that they have been done under "conscious sedation" - I was on general for mine and that seems to be more the norm but as I said I'm not sure.

2) Please be sure whomever does your ablation, that they are the best you can find. If you need to and can travel for the procedure, do it. If its a teaching hospital (not sure re Ohio State) find out who will actually be on the catheters - not who will be in the room, but who is doing the procedure. A friend recently had an ablation at a teaching hospital and the EP and two Fellows worked on him - he was not expecting that.

3) You say your afib is a recent diagnosis and you are anxious or unsure about the ablation, so you might want to consider drug therapy for rate/rhythm control in order to have some more time to figure out the next step. I'm not familiar with Bystolic but it looks like a beta-blocker (why you feel crappy) for high blood pressure, I don't see that its prescribed for rate or rhythm. Again - just a question on my part, not sure if this is an option for you. I was on propafenone for two years and it gave me time to do my research and get mentally prepared for an ablation. I was going to go local but ended up traveling out of state, and am very happy I did - a lot of anxiety over a very smooth procedure. So if you are feeling rushed you may be able to slow the process and get more comfortable.

All the best -

Clay

Thanks for your response. Yes, I will be awake. The ablation is for flutter, not afib. And yes, OSU is a teaching hospital but the doctor doing the procedure is head of the EP department and he will be doing the procedure. While I am a bit freaked out by the procedure I am looking forward to it to get off the drugs which are having side effects. However, the Bystolic is working, I have not had an episode since I started. Atrial flutter is a precursor to Afib which a large number of my relatives have had. So, I want this done and over with as soon as possible. My dad had afib and my sister had Wolfe Parkinson White and she was also awake for her ablation. I think they are expecting it to take around an hour. Let's hope they are correct. Thanks, CJH

That makes more sense - my flutter ablation was under conscious sedation, typically a much simpler procedure with a very high success rate. FWIW mine was a non-event, wishing you all the best on yours!

C

Hi Clay and Cindy,

Clay ... I recall your typical right-sided CTI flutter ablation was a non-event itself, as it certainly should be, though your CTI Flutter circuit was not durably ablated in the first attempt and had to be redone by Dr Natale on the way out of your AFIB ablation just over 3 months ago. CTI flutter is supposed to carry a hight rate of success, which it typically does, but Ive seen a fair number that have reconnected when not done properly and durably even though it should not often fail.

And Cindy, folks with CTI Flutter so often go on to have AFIB .. just like Clay did ... so I also suggest you follow all the life style risk reducing recommendation on our forum and website along with The Strategy protocol for heart calming electrolyte repletion starting now in order to give yourself better odds dds of possibly avoiding progression to AFIB if after dedicating yourself to the kind of good habits that w know can reduce AFIB burden and you still develop AFIB then you will know too to head fairly soon straight to the most
experienced EP you can possibly arrange for yourself to get an expert AFIB ablation process started and completed and not procrastinate too long in that case when you have proactively been doing all the smart self health steps we strongly recommend all AFIBs adopt as good life-long habits of daily life.


Also even for this simpler CTI Flutter ablation I would at the very least request the most experienced EP operator there at OSU who has done the most CTI Flutter case successfully. If you get the sense you will have no say on who does this and it llooos like a trainee will be doing your case, you might well look for other options assuming your insurance is flexible.

Best wishes,

Shannon



Edited 3 time(s). Last edit at 07/01/2017 09:51AM by Shannon.

Thanks Shannon, I saw the first version of your response also. I am very proactive and that is why I'm not waiting on this and I am going to ask about a preventative Afib ablation. I don't expect success but I can put it out there. I saw my dad have nothing but problems back in the early 2000s. He died of a spontaneous brain bleed and his INR was perfect, hence I want off the blood thinners. I was not aware of a strategy protocol and will look for that on this forum unless you can direct me to it. My insurance isn't flexible this year so I have to use OSU. My EP is John Hummel MD and he will be doing the procedure. I thank you so much for answering my questions. CJH

You are welcome Cindy,

You can find here: The Strategy Protocol and also refind it in the future via the yellow horizontal box link above titled 'AFIB Resources' on this forum header. It is the second link just below the top far left link out of the six yellow box links at the top of this forum page. Note too, that 'The Strategy - Metabolic Cardiology' article written by our own Jackie Burgess, is an invaluable document to read and get familiar with. And indeed, the AFIB Resources page is chock full of other excellent articles all about electrolyte repletion and it's relationship to helping to calm the heart as well as many other 'life-style risk reduction' and 'self-health' improvement
good habits that can really help most everyone get a leg up on better long term management of thus condition, including steps to help reduce our contributions to triggering this lousy condition.

Please feel free to download or print out any of these documents in the AFIB Resources link.

Be well and best wishes on our CTI Flutter ablation in a couple weeks, I'm sure you will do well with Dr Hummel and rest assured this is one of the easiest EP cardiac ablations an EP has to perform.

Shannon

Quote
CindyH
I am a former competitive swimmer and have recently read an article about the higher frequency of afib/flutter in swimmers.

Hi Cindy, anybody who has been chronically fit is at higher risk, no matter the sport <[www.afibbers.org] This can also include weight lifters, as I linked to Shannon's report from Dr. Natale here <[www.afibbers.org] and Shannon expanded here <[www.afibbers.org] That being said, for the person who has been more sedentary, becoming more fit can be a benefit to their afib.

It is a balancing act. Part of my afib remission strategy was detraining. I remain very active, but know what my limits and triggers are. For me, too much endurance activity is a trigger. I think high heart rate duration is a component for me.

Shannon mentions the Strategy. For me large doses of magnesium (which is in the Strategy) have been a cornerstone of my remission for over 12 years. Part of the electrolyte balance for me, is to limit consumption of calcium. I was overconsuming for a time and it negatively impacted my remission.

Working out a plan is individual . What others do can give me ideas to try, but they may not work for me. Likewise my program may not work for others.

If something isn't working I do something different. I also tend to look at endpoints. I would push magnesium to bowel tolerance. I've recently backed off that, but still consume a lot compared to most people (1.8 g/day, which would keep many on the toilet!). I backed off much exercise and then added back in to find my limits & etc.

Good luck!

George

Hello and welcome Cindy~ I'm chiming in late but definitely sincere in adding my best wishes to you for a successful ablation. Be sure to keep us posted. If there is anything I can help you with regarding The Strategy protocols, please let me know. BTW, I've had three ablations and they were all with conscious sedation which doesn't cause that huge 'hangover' effect that I've noticed with general anesthesia. Once your confinement period is over and you are able to get up and move around, you'll be amazed at how good you actually feel.

Best to you,
Jackie